NPI | 1942860994 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD61374305) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: OR MD210121) |
207Q00000X Family Medicine (Licence: ND RL15725) | |
Enumeration Date | 2019-06-20 |
Last Update Date | 2024-11-07 |